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Paediatric Tracheostomy and Paediatric Airway Management
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
The fetus is only partially delivered via a lower-segment caesarean section. This allows preservation of the uteroplacental circulation. A 50-min time frame is afforded to perform airway interventions, including establishing an airway, direct laryngoscopy and bronchoscopy, tracheostomy, surfactant administration, and resection of an obstructing mass.
Caesarean Section
Published in Gowri Dorairajan, Management of Normal and High Risk Labour During Childbirth, 2022
In modern-day obstetrics, the caesarean section should be intended and completed as an intraperitoneal lower segment caesarean section. Extraperitoneal caesarean section was encouraged in cases of frank chorioamnionitis to avoid spillage of the infected liquor inside the peritoneal cavity. This technique requires exposing the lower segment by working in the pre-vesical extraperitoneal space. With the advent of antibiotics and advanced management facilities for infected cases, extraperitoneal caesarean section is a forgotten skill.
Infection control precautions with particular reference to women with blood-borne pathogens (hepatitis B or HIV)
Published in Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves, Clinical Protocols in Labour, 2020
Michael S. Marsch, Janet M. Rennie, Phillipa A. Groves
The use of Caesarean section should be discussed with the mother as the optimal mode of delivery. Even in the presence of prolonged ruptured membranes lower segment Caesarean section will still reduce the risk of vertical transmission. If the mother refuses a Caesarean section then avoid any obstetric interventions. Do not perform an artificial rupture of the membranes. If the cardiotocogram becomes abnormal discuss again the use of Caesarean section. Under no circumstances should a fetal scalp electrode be applied or a fetal blood sample be performed. If any such women are admitted to the labour ward, their management should be discussed with the consultant.
Uterine rupture after high-intensity focused ultrasound ablation of adenomyosis: a case report and literature review
Published in International Journal of Hyperthermia, 2023
Yinxia Liu, Na Fu, Bin Lv, Yuedong He, Xiaoli Wang
Unexpectedly, an unplanned pregnancy occurred eight months after HIFU treatment. Due to the aggressive HIFU treatment and short interval time between pregnancy and HIFU, potential uterine abruption during pregnancy was emphasized. However, the patient insisted on preserving the fetus. Since there was no relevant experience to rely on in such a situation, the emphasis on uterine rupture was maintained throughout pregnancy in cases of emergent uterine rupture. The antenatal course was uneventful. Ultrasound scans showed anterior adenomyosis and posterior placenta. The patient was asked to stay near the hospital after a gestational age of 37 weeks in case of medical emergencies such as uterine rupture, as the uterine tension increased with fetus growth. At the gestational age of 38 weeks and 2 days, the patient was admitted to the hospital with slight but continuous abdominal pain. Fetal monitoring results were unremarkable. An emergency lower segment cesarean section was performed because uterine rupture could not be excluded.
Factors contributing to late stillbirth among women with pregnancy hypertension in a developing country
Published in Hypertension in Pregnancy, 2020
Manisha Kumar, Ravi Vajala, PhunstokDoma Bhutia, Abha Singh
Table 3 describes the delivery details of the study subjects. Although most of the women in both cases and controls were in the gestational age group of 35–38 weeks, the cases presented earlier (mean 34.6 weeks ±4.9) than controls (36.9 weeks ±3.4) (p = 0.001). The lower segment cesarean section (LSCS) was done in 16.8% (35/208) cases. It was done for various indications like abruption with massive hemorrhage (10 cases), pulmonary edema, previous two LSCS (4 cases each), previous LSCS with scar tenderness, transverse lie, twin with one live baby in distress, first twin other than the cephalic presentation, contracted pelvis, and eclampsia with non-progress of labor (3 cases each). Placenta previa (2 cases), previous one LSCS with deep transverse arrest (one case).
Charcot–Marie–Tooth (CMT) disease and pregnancy: a case report and literature review
Published in Journal of Obstetrics and Gynaecology, 2020
Rayan Itani, Naela Elmallahi, Abdullah Al Ibrahim
The antenatal period was uneventful except for gestational diabetes mellitus and iron-deficiency anaemia, which were controlled through dietary modification and replacement therapy, respectively. Neurologically, the patient complained of nocturnal numbness in her right hand at eight months of gestation, but denied any weakness of the hand or cramping pain in the legs. Subsequent physical examination revealed a new-onset bilateral foot drop, areflexia and decreased muscle mass below the knees. Otherwise, the patient was capable of ambulating independently. Regarding her foetus, the periodic ultrasound scans throughout the pregnancy revealed reassuring growth measurements and the absence of any anomalies. At her 37th week of gestation, the patient presented to the emergency department with labour pains and underwent a lower segment Caesarean section, in light of a previous history of two Caesarean section procedures, during 2013 and 2015. As part of the pre-operative assessment, the patient was counselled about general anaesthesia (GA) and spinal anaesthesia; both viable options given the absence of any respiratory involvement in her case. Her two previous Caesarean section operations were under GA and uneventful. The patient decided to undergo spinal anaesthesia and gave birth to a male baby. The baby weighed 2835 g with Apgar scores of 9 at 1 minute and 10 at 5 minutes. The umbilical artery pH was 7.33 with a 1.7 base excess. The patient recovered spontaneously, had no complications, and was discharged home with a neurology follow-up appointment.